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Dr. Udo Schuklenk

Conversations about dying

In 1993, Sue Rodriguez, a Victoria, B.C. resident suffering with Amyotrophic Lateral Sclerosis (ALs), initiated a controversial and important national discussion in Canada on the issues surrounding end-of-life decision-making by petitioning for the right to choose assisted suicide. Her petition was denied – but since that hallmark decision, Canadians have continued to form opinions about assisted dying, euthanasia and the quality of their end-of-life experiences.

Now, with new end-of-life cases coming before the Supreme Court, the Royal Society of Canada has re-ignited that debate with a review led by Queen’s researcher and bioethicist Dr. Udo Schuklenk that examines public policy and public opinion about how we want to die.

Schuklenk joined Queen’s in 2008 as the Ontario Research Chair in Bioethics and Public Policy, and is editor and author of two leading bioethics journals, five books and more than 100 peer-reviewed articles. He was chosen by the Royal Society to lead a panel of experts from across a broad scope of disciplines, including health law and policy, bioethics, clinical medicine, and political philosophy. The panel was charged with exploring the emotional and often controversial issues around end-of-life decision-making, including social attitudes, demographics, ethical concerns, Canadian experiences at the end of life, and international practices and statistics.

Schuklenk says that the review – and subsequent discussions at all levels – are timely and necessary.

"Public support for the decriminalization of assisted suicide and voluntary euthanasia remains high, and yet these activities remain prohibited under the Criminal Code of Canada," says Schuklenk. "Our role was to address the very important social and ethical issues around end-of-life decision-making to help Canadians and policy makers have a knowledgeable discussion around these critical matters."

Along with providing an objective review of these issues, the report also examined a wide range of related policies and practices affecting Canadian experiences at the end of life, including the use of palliative care, mortality trends, location of death, and the prevalence of advance directives that outline wishes for care at the end of life should an individual be unable to communicate.

The report also provided important data around similar practices in other countries, particularly to address what Schuklenk describes as the "slippery slope" argument.

“There is always concern that by decriminalizing assisted dying, we will increase the chance of abuse of the practice,” he says. “In fact, we found that decriminalization tends to lower the incidence of abuse.”

Given our aging population, Schuklenk says that it’s time for Canadians and governments to have important conversations about end-of-life care and practices. “There’s no doubt that these discussions are controversial and at times difficult,” he says, “but they are conversations that every Canadian deserves to have."